I am not Iron Woman...

June 29, 2010 7:43 PM

Personal anemia anecdotes wanted: How long did it take you to feel human again after being diagnosed with anemia?

I had been feeling exhausted for the past month or two and wrote it off as me working too hard. About a month ago I got some sexy angular cheilitis around my mouth, which, after some quick investigation, I discovered is symptom of anemia (Other wacky symptoms of anemia that I have are: chewing ice, mood swings, twitching muscles, short temper, tiredness/exhaustion/fatigue, dizziness, and poor appetite - unless it's ice).

So I started taking an iron supplement daily - "Gentle Iron", which is ferrous bisglycinate and contains 29 mg of elemental iron. The angular cheilitis went away after a week or so and some copious amounts of Neosporin. Yes, I take it with orange juice and no, I do not take it within at least two hours of any food or drink containing dairy, caffeine, or tannins.

I had my routine blood tests a few weeks later and my doctor's PA called last week to tell me that I was severely anemic and that the doctor wants me to take 324mg of ferrous gluconate once a day. That's only 27 mg of elemental iron. And it fucks with my insides worse than the ferrous bisglycinate does. I told the PA that I'm already on an iron supplement and she blew me off. (I adore my MD but I really hate her PA.) I went ahead and switched to Bifera for the time being, and have ordered a bottle of Proferrin (both have heme iron, which is more bioavailable and can be taken with food and do not seem to cause gastrointestinal disturbances).

Anyway. Assuming that I've been exhausted/anemic for months and that I started taking an iron supplement about a month ago, and I'm taking a double supplement now (I am aware of the dangers of iron overdose, but I am a woman of childbearing years who doesn't eat many iron containing foods), how much longer can I expect to feel dead on my feet?

Have you been anemic? How long did it take for you to not fall asleep at your desk every day? Until you could come home from work and do things around the house besides nap? Until going out and doing things sounded like fun rather than a chore? Until you stopped eating 80+ ounces of ice a day? Until you stopped being Dr. Jekyll and Mr. Hyde?

I need a light at the end of this anemic tunnel! Please hope me!

posted by elsietheeel to health & fitness (19 answers total)

is there going to be some sort of investigation into why you are so anemic? being a woman of childbearing age (by which I am assuming you are implying that you menstruate regularly?) is not a complete reason for being anemic to this degree for so long. i think answering that question would help you out with the rest of your issues. your md should be on this....
posted by Tandem Affinity at 8:02 PM on June 29, 2010

I feel your pain, as a former Proferrin taker who finally just started eating red meat. I usually clock in at a paltry 8 hemoglobin level when I'm not careful.

but I am a woman of childbearing years who doesn't eat many iron containing foods

Is there a reason you don't eat iron-rich foods? Are you vegan? Even stuff like Proferrin isn't as gentle on your system as just getting iron from real meat. Iron pills are fuck-all painful, feel awful to digest and pass, and generally far more trouble than simply eating iron-rich foods.
posted by zoomorphic at 8:05 PM on June 29, 2010

Gastric bypass and IBS. I'm limited in quantity by the size of my stomach, and red meat does a number on my insides. I do what I can, but ultimately it's not going to get much better by just eating food.
posted by elsietheeel at 8:21 PM on June 29, 2010

You might call your GI specialist and let them know, and see if they want to take a peek and rule out anything with your bypass that might be causing bleeding.
posted by fairytale of los angeles at 9:02 PM on June 29, 2010

My bariatric surgeon knows and is currently not concerned. Anemia is common in post-WLS patients (I had the surgery 18 months ago), given the reduced capacity for food and changes in the absorption of nutrients.

If the levels don't improve by my next blood test (in August) then that will be something to bring up again. Thanks though.

I'll ask again... Does anyone have any personal anecdotes/experiences about recovering from anemia? Please? I feel pretty hopeless right now.
posted by elsietheeel at 9:17 PM on June 29, 2010

I've been anemic, but it was a couple of decades ago. I can't clearly remember how long it took after starting iron supplementation to start feeling normal. (And stop chewing down on four ice cube trays' worth of ice a day, ha, I do clearly remember the irresistible siren song of the cold and the crunch. I'd have eaten more if we'd had more trays.) Best guess, maybe a month or two. Honestly though, I don't remember the timeframe. I just remember looking at ice cubes one day and marveling that for the first time in months, I didn't feel any compulsion to crunch them.

The iron pills gave me constipation, so I switched to Floradix liquid, which made my GI tract happier. Good luck. I'm sorry I'm not more helpful.
posted by cybercoitus interruptus at 9:24 PM on June 29, 2010

A lot of people who are anemic don't even realize it, and do not have symptoms that significantly affect them the way you are having. That may be why you are not getting many responses.

I've been anemic before, apparently pretty profoundly. I hardly noticed, fell asleep more often than usual, but I am a night owl and do this anyway. Took iron supplements and hormonal birth control pills to limit menses, and the daytime napping improved in a few weeks.
posted by treehorn+bunny at 9:29 PM on June 29, 2010

I have been severely anemic, to the point where I was having trouble walking without falling down. There is honestly very little that is more depressing than being severely anemic. It saps your will to live. You have my sympathies.

I'd say it took me probably about 2 months to really recover. I was talking Palafer (300 mg Ferrous Fumarate) twice a day for that entire time, and then shifted down to one a day for a while longer. I still keep some around because I keep fighting anemia and I don't want to get that sick again.

I've been more mildly anemic as well, and when less ill I find it takes about 5 days of iron before I feel the sudden surge of energy. Severe anemia is tougher. I didn't ever feel the sudden surge like that, it was much more gradual. Once I got that diagnosis I basically did nothing but sleep for about 10 days. I had been tired enough to do that, but once I understood what the problem was, I just stopped fighting it and took the time off to recover. After that I could manage getting out of bed like a regular person again.

I'm sorry you're having trouble with your stomach when taking iron. There are other options, but of course the quickest way to deal with severe anemia is to take the strong stuff, as much as you can manage. I've discovered that the more anemic I am, the less trouble I have with Palafer. Right now my iron levels are on the low side but are reasonable, so if I take a single Palafer I will feel it. But as I say, I went months on two of those a day with few side effects.

If you want to know whether you can get away with your gentle iron instead of Palafer, ask your pharmacist for some advice, and bring the stuff you're taking with you. There may be more to it.
posted by Hildegarde at 10:28 PM on June 29, 2010

I was severely anemic close to 20 years ago. I absolutely had symptoms. I would easily get out of breath and would pass out anytime I stood up quickly or lifted my arms above my head for any length of time. I also ate ice like it was going out of style and had the sores at the corners of my mouth. It also seemed like my heart was pounding all the time. Even though it's been a long time, I still have an unreasonable fear that I will get sick like that again because it was so horrible--I thought I was dying. I took high doses of iron supplements 2 or 3 times a day (been so long I can't remember the dose or the frequency), ate foods high in iron, and cooked everything possible in cast iron cookware. I pretty much tried anything and everything to get iron into my body that didn't involve IVs/transfusions. It took me months before I started feeling like a normal human again. I want to say about 4 or 5 months. I know the hopeless feeling you're talking about. It does get better. It just takes a while but it does get better.

As a side note, I kept going to my doctor off and on for a while only to be told everything was normal. He even told me it was all in my head after I kept complaining about my symptoms and telling him something had to be wrong with me. It wasn't until my mom became insistant that I go elsewhere that I went to a nurse practitioner who diagnosed me with severe aenimia within the first few minutes of my first appointment. I'm still bitter and very angry that I lived like that for a several months and being told that it was all in my head. It was hell.
posted by GlowWyrm at 11:16 PM on June 29, 2010

I have a type of congenital auto-hemolytic anemia (i.e. my body continually breaks down my own blood supply, thanks to a congenital red blood cell morphology disorder called hereditary spherocytosis). I spent much of my childhood getting progressively weaker and more tired, and was thin as a rail. Eating lots of red meat, sleeping a lot, and folic acid (not iron!) supplementation are pretty much the only things that I've found to help, in my case -- aside from getting my spleen surgically removed at age eight, that is, to cut down on the auto-hemolysis. :-/

So yeah, you certainly have my sympathies, but you should also count yourself lucky that you'll be feeling better pretty soon, with nothing more needed than dietary supplements... I know anemia sucks, but just keep in mind that your situation has been diagnosed and will hopefully be transitory. In the meantime, your local butcher should become your new best friend. I seriously ate steak and burgers at least five nights a week as a kid.
posted by Asparagirl at 12:57 AM on June 30, 2010 [1 favorite]

I have a friend who became severely anemic in college. Part of her problem was that she's very introverted to begin with, so people didn't know she was going nuts during her private time (which was at least 60% of her day) and just that she'd started to fall asleep in public places like lounges before classes and she was getting paler and bitchier. Then, during finals, she fainted.

Don't worry, they fixed her up. It took her about the length of summer vacation to come back to normal. Because she's stubborn as hell she still occasionally lapses back into low-level anemia, and she is still an ice-cruncher, much to our annoyance during movie time, but she's in control of her own body now, and knows what to do to make herself better. She also was a theater person, who dances and sings (she's the type of quiet person who "turns on" for the stage, you know?) and she fully regained her cheerful "on" abilities and charisma with no ill-effects.

Give yourself two more months of crap time. Don't give up hope! You just have to have a little dedication and endurance.
posted by Mizu at 6:09 AM on June 30, 2010

Thank you for the anecdata, folks. I feel more hopeful this morning. Still exhausted, but hopeful. Maybe I'll feel better in another month or so. I'm very much looking forward to my August bloodwork (possibly the first time I've ever wanted to have blood drawn).

And I'm totally having a hamburger for lunch today.
posted by elsietheeel at 7:14 AM on June 30, 2010

So glad you asked this because I was going to ask my own anemia-related question. I was diagnosed with basic iron deficiency anemia almost two months ago. I have been on two tabs of SlowFe per day (50 mg elemental iron per tab) and was only just, as in within the last week, starting to feel remotely more human. I'm under the care of a good internist and fantastic nutritionist.

While my incredible fatigue (constant sleeping, never feeling rested, every movement felt like a gigantic effort, flat affect, too drained to care, etc.) and my getting very sick over and over and over stopped within a couple weeks of taking the iron, no WAY am I back to my normal energy levels. I am a runner who has not only been unable to run but the anemia has sapped all passion for movement--I just can't do it and don't want to. Until last week, I didn't even have the energy to miss running, which is a huge change for me. I just got back to running (very short jogs) which my doctor and nutritionist cleared me to do as long as I keep my heartrate within a certain range. Let me tell you--the fatigue is back. I need more time off. It's been about 8 weeks on iron and I'm still not feeling human again. Hang in there. My nutritionist assured me that this is not uncommon with my levels of iron.

Make sure you're getting good care and regular bloodwork. I am guessing you are, but, you know, if your body isn't responding the iron/nutritional corrective measures, something more could be going on there.

Best of luck. Anemia really, really, really fucking sucks.
posted by Rudy Gerner at 7:22 AM on June 30, 2010

I would echo what fairytale of los angeles recommended. It's a great idea to rule out anything causing internal blood loss, especially if you're at particular risk for it, like having had GI trouble or surgery.
posted by Rudy Gerner at 7:27 AM on June 30, 2010

Again, my GP and my bariatric surgeon are aware of my blood test results and are not at this moment concerned about internal blood loss. Neither am I. All of my other test results came back normal: D, B12, Folic Acid, Calcium, TSH, T4, etc. (My lipid panel was amazing! Total cholesterol of 165 and my HDL was 71! Sorry, very proud of that one.)

Anyway. Anemia is very common in gastric bypass patients. Iron absorption occurs primarily in the duodenum, which is no longer a part of my functioning GI tract. This, coupled with the fact that I do not generally eat iron-rich foods, is the likely cause of the iron deficiency anemia.

Thank you again for your concern.
posted by elsietheeel at 8:20 AM on June 30, 2010

Sorry, didn't mean to be off topic or repetitive.
posted by Rudy Gerner at 8:58 AM on June 30, 2010

You weren't. I really do appreciate the concern and your first answer was very good. :)
posted by elsietheeel at 9:03 AM on June 30, 2010

Bah, my wife took forever to recover from anemia. Eventually we saw a brilliant-yet-eccentric doctor at Brigham & Womens Hospital in Boston and he got her on the right iron supplement. She's now down from two a day to one a day, and no longer feels lightheaded, etc. Many women experience big drops in their iron stores after pregnancy. We have four kids, so her body never really recovered from each one before the next baby came along and zapped her again.

Agreed that *all* the causes should be investigated. Sounds ilke you know what yours is, but still. :7) A couple of other docs (the OB/GYN, an Ivy League hematologist, a renal/blood specialist, and The World's Worst GP) all kind of shrugged. In the end the kooky genius couldn't come up with a definitive answer besides "Some people just don't absorb enough iron. *Gallic shrug*" But at least he used science and reasoning to get there.

In your case, a well-known cause will help select a good treatment, so it may only be a couple of months before you're your old self again. Hang in there.
posted by wenestvedt at 9:29 AM on June 30, 2010

He even told me it was all in my head after I kept complaining about my symptoms and telling him something had to be wrong with me.

This happened to me, too! The doc had my blood test results in his hand, which were showing that I was anemic, and I was exhibiting classic symptoms (pica, twitchy legs, tired, weak, and short of breath) and he told me that although he doesn't like playing the "psych card," he thought it was all in my head. When I burst into tears of frustration, he asked me if I always "got worked up like this." Ass.

Anyway, my symptoms weren't as bad as yours, elsietheeel, and I've been ramping up my iron intake over a few months (started with 18mg, added another 18mg, learned that taking it with my morning coffee was bad, then started making a serious and concentrated effort to eat more iron-rich foods) so it's hard for me to pinpoint exactly how long it took to feel better. Actually, as I am writing this I realize I haven't wanted to eat things that aren't food in a long time, and I can run up the stairs to my apartment without losing my breath. From what I've read, a few months at least, or longer for severe anemia.

I know you're limited with what you can eat because of the gastric bypass, but maybe your bariatric surgeon can recommend some high iron foods that will be easier on your stomach. Fortified oatmeal and raisins, for example, has a lot of iron.

Good luck!
posted by jennyb at 4:00 PM on June 30, 2010